Tuesday, 13 November 2012

How to Manage the Risks of Patient Wandering

Patients living with dementia or
Alzheimer’s can be prone to wandering. Unfamiliar environments like the
hospital can increase the likelihood of wandering, which can create a challenge
for hospitals to manage at-risk patients and ensure their safety at all times.

One of the biggest concerns for wandering
patients in the hospital is falling, either when getting out of bed or when wandering.
Exiting the hospital bed without nurse assistance can cause patients to trip or
fall especially when experiencing altered perception at
unfamiliar heights. Wandering through the hallways can lead to stumbling and
tripping caused by weakness and disorientation. When patients fall, serious
injury such as fractures, lacerations, or brain injuries can occur.

Most wandering prevention programs are put
in place when a patient has been identified as a wandering risk. If a patient
has not been diagnosed with dementia or Alzheimer’s, hospital staff may not
realize immediately that the patient could be prone to wandering.

As a result, elderly patients should be
screened for any signs of a memory problem or disorientation upon admission.
This process can be similar to a fall risk assessment and should look for signs
of memory loss or cognitive impairment. Since a patient’s condition can change
throughout a patient’s stay, staff should continually observe patients for
changes in functioning, mood, or awareness while simultaneously assessing fall
risk.

If a patient’s mental condition changes, or
if the patient has been assessed as a wandering risk upon admission, staff will
need to ensure that there is regular supervision to minimize risk. Hospitals
can use any combination of the following strategies to reduce wandering:

·Sitters

·Bed-exit alarms

·Locating the patient’s room
near the nurses’ station

·Hourly nurse rounding

·Watching for indications that
the patient is trying to leave

Sitters can be a costly method to reduce
patient wandering, but does employ constant supervision to eliminate wandering.
A more cost-efficient solution would be to use a bed-exit alarm to monitor when
a patient is exiting the hospital bed or showing signs of movement. When a
patient is located close to the nurses’ station, staff can quickly respond and
return the patient to bed or provide help if a patient requires toileting
assistance.

Hourly nurse rounding can be used alongside
a bed-exit alarm for regular supervision of wandering patients. Each hour,
nurses can check in on patients and assess the patient’s condition and mental
state. If a patient is confused and is asking about family members, this may
indicate that a patient may be looking to leave the hospital bed to find his
loved ones. When a patient is tying up shoes or putting on a coat, this is also
an indication of wandering that should be addressed through intervention.

However, since patient wandering is not
always entirely preventable by nurse intervention, staff should ensure that
safety measures are put in place for when a patient wanders:

1.Use a low hospital bed to
reduce falls and injury when patients get out of bed unassisted

2.Ensure patients are located far
away from exits, stairs, and other hazards

If a patient does leave the bed without
nurse intervention, low hospital beds can provide a safe resting height that
can minimize the risk of injury from trips and falls out of bed. Assuring that
the patient is located far away from exits, stairs, and other dangerous areas
can limit the adverse events that can occur when a patient wanders. Appropriate
footwear should be worn by the patient at all times to minimize the risks of
slips and falls.

Maintaining a safe environment for patients
is the key to creating a wandering management and prevention program in your
facility. Implementing the necessary steps to identify patients who are at-risk
of wandering can prevent slips, trips, falls, or other adverse events that can
occur when a patient wanders.CHG Hospital Beds specializes in low hospital beds that are designed to prevent patient falls and related injuries within acute care environments. We are focused on patient and nurse safety and deliver innovative solutions to meet the needs of our customers.Subscribe to the CHG Blog today!

Thanks for sharing such an interesting post. To Manage the Risks of Patient Wandering the Hospital Management have to be very strong and careful. They should collect and save all the information about patient health for providing better care.